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interposition of the capsule. On the right side the liga- imentum teres was found to be represented by a curious’ ,leaf-like structure continuous with the cartilage, and having 1no connexion with the acetabular cavity. On the oppositeside destruction of the ligamentum teres had proceeded to a Ilesser extent. These facts explained many recorded cases inwhich the ligamentum teres was said to be altogether 1absent. In each case of the kind the extent to which theligamentum teres underwent absorption was simply a i

question of time. Had the girl lived a few years longer the 1

ligament would have appeared to be entirely absent, and Ithe dislocation attributed probably to its absence. Inthe majority of cases it was present, but undergoing Iabsorption. The other specimen was one which he hadhimself dissected, and it repeated all the phenomena ofthat of the case from Sir Patrick Dun’s Hospital.

Dr. KILGARIFF exhibited a large Cervical Tumour re-moved by him from a young woman aged twenty-five. Asimilar growth had been removed from the same place sixyears before. It implicated the lower part of the ear, the’face, and the ramus of the jaw, the side of the neck over-lapping the clavicle, and lying on the sheath of the carotidand deeply embedded in the parotid region. It becameulcerated six months before operation, and she became muchreduced by the hsemorrhage from the ulcer. Photographswere shown of the patient before and after the operation,which proved very successful. Mr. Coppinger having ex-amined the growth, reported that it was encapsuled, andthat the fresh section showed large translucent areas.

Microscopically the sections presented the characters ofmyxomatous tissue. The outer parts were chiefly made upof lymphoid tissue. He considered it a lympho-sarcoma.

Dr. J. W. MooBB exhibited some large Gall-stones. In1882 he had presented to the Pathological Society a series ofgall-stones which had been passed by an elderly woman afterterrible suffering. A peculiar feature of the case was thatthere was very little icterus, explained probably by theremarkable faceting of the calculi. The calculi had beenin his possession since last summer. The woman recoveredperfectly.

Dr. BARTON exhibited a specimen of Bowel Obstruction.The patient, an engine fitter, aged thirty-four, had sufferedoccasionally during six months from derangement of thedigestive organs. He had no history of dyspeptic symptoms,but complained last summer of colicky pains after food, apeculiar pain across the abdomen with a sort of gurgling. Thesesymptoms occurred at irregular periods, and in the intervalhe had good health. On Christmas Eve he had a severe attackof abdominal pain and obstinate constipation. For ten dayshe suffered from these symptoms, with partial obstruction,swollen abdomen, and peristalsis of the intestines, perceptiblethrough the abdominal walls. He had occasional action ofthe bowels, produced by enemata, in which the excreta wereof a soft character. When admitted into the Adelaide Hospitalon the 5th inst., his abdomen was swollen, the chief pointof pain being on the right side over the csecum. Pressureon the rest of the abdomen did not cause much pain. Heappeared like a person suffering from strangulated hernia.He had a long drawn face, and vomited matter of a dis-tinctly faecal character. It was concluded he had intus-susception of the ileum to the large intestine at the ileo-caecalvalve. The swelling had increased to such an extent as toaccount for the total obstruction which existed for threedays. He was put under opiate treatment. Having gone pre-pared to operate, Dr. Barton found the patient had free actionof the bowels, which was followed by a second after his arrival,the faecal matter being soft and fluid, evidently from the smallintestine. The abdominal swelling andpainhaddiminished andthe vomiting ceased, although he could not retain food. Forthe next five days the treatment was on the suppositionof inflammatory obstruction, not an intussusception. Hegained ground till three days ago, when the pain andvomiting returned, and, treatment availing nothing, itwas determined to operate. Opening the abdomen as

a tentative measure, to ascertain the pathological condi-tions, Dr. Barton made an incision from the umbilicus down-wards, and found that the parts about the csecal valves werenot obstructed. The ileum was thickened and the cascumenormously distended, but there was no intussusception.At the transverse colon he discovered a hard mass with ahard band of lymph around it, about as thick as the littlefinger, and he divided it. Immediate relief followed. This

iwas only part of the diseased mass, and he excised a portionof the transverse colon and sewed the cut end of the

ascending colon to the upper end of the wound, the rest ofwhich he fastened up, so that the man, who was still alive,had got a false anus. The operation occupied two hours.Whether the man would survive or not was doubtful, theshock having been very great. The wall of the intestinewas occupied by a mass which nearly filled the cavity,leaving passage barely for a quill pen. The fizzing noisewhich attended his temporary relief from pain and obstruc-tion months back was evidently caused by the passing ofthe liquid fasces through the opening. The obstruction wasof the inflammatory kind, though the mass was exceedinglyhard. It grated under the knife, and seemed of a fibrouscharacter. The condition of the ileo-caecal valve was thatof inflammatory thickening.-A discussion followed, inwhich the President, Dr. Warren, and Dr. Doyle took part;and Dr. Barton having replied, the section adjourned.

CAMBRIDGE MEDICAL SOCIETY.

AT the meeting on Feb. 6th, Dr. Bradbury in the chair,Dr. BOSWELL (Saffron Walden) related a case of Supposed

Cerebellar Embolism. Early in May, 1884, he was calledto see a patient, aged fifty, suffering from rheumatism,which shortly after assumed an acute form. The salicylictreatment was adopted and the disease checked, though notbefore an impurity of the heart’s first sound had becomenoticeable over the mitral and aortic areas. On June 7thshe was able to sit up, and felt very well. Next day,while quietly resting in bed, she suddenly pressed her handsover her head and with a cry of terror fell over. She wasconscious, but unable to articulate; the face was greatlyflushed and somewhat swollen, the conjunctives were con-gested, the eyelids dropped, and the pupils much contractedand turned upwards. Nystagmuswas observable when the eyesdescended. There were, moreover, very remarkable writhingmovements, the patient all the while lying close to the bedand not raising herself from it in the least. There was noindication of any form of paralysis, either motor or sensory.The reflexes were exaggerated. Next day she was able tocommunicate her sensations. She was suffering from anoverwhelming sense of vertigo, objects appearing to be

whirling round her, not laterally, but from behind forwardson a vertical plane. The left pupil remained contracted forthree weeks. She complained much of extreme photophobia,and consequently an ophthalmoscopic examination was notpossible. Tinnitus aurium was also a marked feature.There was no evidence of inflammatory mischief, and thetemperature was normal. The bloodvessels were healthy.In this condition of extreme prostration, with total inabilityto raise her head from the pillow, she remained for severalmonths. Latterly she has improved somewhat, and has beenable to sit up a short while each day, to occupy her time alittle with reading and needlework, and to walk round herbed once or twice daily. But she is still unable to occupyany but a horizontal position except for a very short time,and the vertigo and other sensations are very easilyproduced, particularly by any change of character in thevisual impressions-such, for instance, as viewing her roomfrom a different standpoint, or occupying a couch of lowerlevel than the bed she habitually occupies. The probablepathology of the case was discussed, and the view adoptedof an embolus being impacted in one of the cerebral arteries,or in a branch of the posterior cerebral artery on the left side.The experiments of Flourens were referred to as indicatingthe results of injury to various portions of the cerebellum,and also as affording grounds for a favourable prognosis.Mr. W. R. POLLOCK showed a specimen of Fracture of

Pelvis with Wound of Artery. The patient was fifty-sixyears old, and very stout; he was admitted into the hospitalon April 9th, at 10.30 P.M. He had been knocked down bythe buffer of a passing engine, but not run over; the blowwas on the buttock. He was suffering great pain and wasquite unable to walk, but his pulse was good and there wasno sign of shock. He was put to bed without furtherexamination, and he died about 5.30 A.M. on the followingmorning. The necropsy revealed a fracture of the pelvisand a spicule of bone penetrating the left internal iliacartery, causing internal hoemorrhage ; there was alsofracture of two or three of the upper ribs on the left side.Mr. Pollock remarked on the absence of shock or collapse,and the long time the patient lived after the wound of alarge artery. The hemorrhage was very gradual, although

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the wound of the vessel was considerable. He referred tothree cases recorded in THE LANCET by Mr. Clement Lucasof fractured pelvis with wound of either the iliac vein orartery; one patient living for six hours with a wound of theexternal iliac artery.Mr. ROGERS (Fulbourn) showed a specimen of Sarcoma of

]Kidney removed from a lunatic in the asylum. Haematuriawas first noticed in April, 1883, lasting for ten days andaccompanied by pain. The patient recovered, but inDecember continuous haematuria persisted, until deathoccurred in November, 1884. A growth was found in thekidney, occupying a large portion of its pelvis and extendinginto the medulla and cortex; on section it showed severalhaemorrhages and cystic degeneration. Microscopically itproved to be a sarcoma, with some indication of an alveolararrangement. There were some calculi in the lower part ofthe pelvis of the kidney, the association of which withmalignant disease was noticed. There were no deposits inthe other organs.

MIDLAND MEDICAL SOCIETY.

AN ordinary meeting of this Society was held on Feb. 18th,the President, Mr. T. H. Bartleet, F.R.C.S., in the chair.

ilir. Ross JORDAN read a paper on the Social Aspect ofImbecility and Insanity. He pointed out the great im-portance of the subject and the desirability of the medicalprofession being prepared to advise their patients in suchcases. After speaking of the early symptoms of insanityand their importance, it was urged that if home treatmentdid not speedily cure or improve the patient he should in allcases be sent to an asylum. He deprecated the practice ofkeeping insane patients at home. He pointed out thatepileptics often have long intervals of sanity under control,but that the attacks are much more frequent and dangerous I,when at home. Moral insanity and some special manias inhis opinion are not sufficiently recognised by law; it shouldbe made legal to detain and treat many of these cases. ’,The difficulty and danger of diagnosing and certifyingprivate patients in the present state of the law were enforced,and the right of appeal to experts appointed by the Com-missioners in Lunacy was suggested.

Mr. JORDAN LLOYD showed the parts removed from aStrangulated Congenital Hernia with Testis retained in theInguinal Canal. The patient had been ruptured since child-hood. Two days before admission the rupture came downwith symptoms of strangulation. Operation was performedon the third day, the sac and atrophied testis being excised.He left the hospital on the twenty-third day without animpulse and is wearing no truss. Mr. Lloyd also exhibited eightother hernial sacs recently removed by himself. He alsoshowed a specimen of Infiltrating Lympho-sarcoma removedfrom the Posterior Triangle of the Neck. The growth seemedto begin in the deep cervical fascia, and at the time of theoperation had infiltrated the platysma and sterno-mastoid,the clavicular part of which was removed. The patient leftthe hospital on the twenty-sixth day with the woundsoundly healed.Mr. BENNETT MAY exhibited a specimen, taken from a man

aged fifty-four, of Cancer of the Caecum of the ordinarycylindroma form, which, by compression of the duodenumat its second bend, had caused death by protracted starvation.The intestinal symptoms being slight, and no tumour beingperceptible for some time, the case was difficult of diagnosisin its earlier stages, and was further complicated by theformation of a large abdominal abscess due to ulceration.

lir. EALES showed a man in whom the Iris was completelyabsent in each Eye. Both lenses were opaque, after thezonular type, but with many strias in the clearer outer zone,and in each eye the lens was abnormally placed, being nearer theupper than the lower corneo-scleral junction. The removalof the lens in one eye showed the vitreous to be quite fluid.He also exhibited a girl, aged twelve years, suffering fromColoboma of the Iris and Clioroid in the left Eye. The eyewas hypermetropic, and the differencesn refraction betweenthe margin of the coloboma of the choroid and its deepestpart was eight dioptrics.

SUPERANNUATION.—Mr. A. J. Verity, late medicalofficer for the Bridgend district, the workhouse, and thecottage homes, has received a superannuation allowance of29 a year.

Reviews and Notices of Books.Atlas of Female Pelvic Anatomy. By D. BERRY HA,T,1lZ.D.

W. and A. K. Johnstone, Edinburgh.WE have on previous occasions noticed with pleasure the

work done in the anatomy of the pelvis of the female byDr. Berry Hart, and published from time to time. His

researches into the anatomy of the pelvic floor and of the"genu-pectoral" position are of the greatest value. The

imagination has been permitted to run riot by writers uponthese two subjects, in evolving the functions of the one andthe effects of the other, but the investigations of the authorhave brought them back within the realm of fact, a serviceof incalculable value to women. His researches into these

subjects will contribute materially towards forming a basisfor a true physiology and pathology of the parts inquestion. The Atlas of Female Pelvic Anatomy containsthe illustrations of the subject already published byDr. Hart, some new illustrations, and a large numberselected from the works of others. The work consists of

thirty-seven plates- almost every plate contains severalfigures, -and an appendix on the nervous mechanism ofthe bladder and the etiology of flexion. The plates are

accompanied by descriptions, explanations, and practicalremarks. They are grouped into six sections. The firstseventeen plates are descriptive (as opposed to sectional) ofthe external genitals and the internal pelvic organs; thesecond section consists of three plates, chiefly of the fasciaeand muscles of the pelvis; the third illustrates in eightplates the sectional anatomy of the pelvis; the sections

being made in various planes, transverse and perpen-dicular-in the pregnant and unimpregnated condition.Some of the figures in this section are diagrams, andfor that reason alone their appearance is to be regretted,especially as they have been published by their designersto explain or illustrate theories the correctness of which isstill questioned. The fourth section gives the anatomy ofthe pelvic floor and of the " genu-pectoral" position, whichwe have already stated Dr. Hart has rescued from cloudland.In the fifth section is given the state of the cervical canalduring pregnancy and labour; the sixth and last is devotedto microscopic anatomy. We need add nothing to what wehave said about the author’s original work, which is repro-duced in the Atlas. The task of selecting from the worksof others has been on the whole well and judiciously done.Many of the subjects illustrated are still under discus-

sion, and opinions the most opposite are held respectingthem; consequently illustrations taken from specimensalone can be of any value; diagrams are useless, anddo not add to our knowledge. With the exception ofthe diagrams above referred to, the selection for thefirst four sections has been done well. With regardto the fifth section, however, which illustrates the con-dition of the cervix during pregnancy and labour, the authorhas not been so fortunate. The subject is one whichhas by no means been settled since it was reopenedby Bandl, by the publication of his memoir " Ueber dasVerhalten des Uterus und Cervix in der Schwangenschaftund wahrend der Geburt," in 1876, and it is not likely tobe settled yet awhile. The illustrations in the Atlas fail to

give a just and fair representation of the present state ofthe subject-do not give some of the most important figuresof what has been seen, drawn, and published. The micro-

scopical section is extremely deficient. With the exceptionof three illustrations on wood, the plates are of sections ofthe vagina and external parts, and show but little. Manyof the illustrations were obtained by first photographingthe specimens and then tracing them. This method has the

advantage of accuracy, but it has disadvantages which render